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Michael J Ingargiola, Felipe Molina Burbano, Amy Yao, Saba Motakef, Paymon Sanati-Mehrizy, Nikki M Burish, Lisa R David, Peter J Taub
Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the ACGME highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. Objectives: The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States...
March 14, 2018: Aesthetic Surgery Journal
Giuseppe Marulli, Giovanni Maria Comacchio, Marco Schiavon, Alessandro Rebusso, Marco Mammana, Davide Zampieri, Egle Perissinotto, Federico Rea
OBJECTIVES: Minimally invasive techniques seem to be promising alternatives to open approaches in the surgical treatment of early-stage thymoma, although there are controversies because of lack of data on long-term results. The aim of the study was to evaluate the surgical and oncological results after robotic thymectomy for early-stage thymoma compared to median sternotomy. METHODS: Between 1982 and 2017, 164 patients with early-stage thymoma (Masaoka I and II) were operated on by median sternotomy (108 patients) or the robotic approach (56 patients)...
March 13, 2018: European Journal of Cardio-thoracic Surgery
Luis Anel-López, Olga Garcia-Álvarez, Tatiana Tarantini, David Del Olmo, Jose Antonio Ortiz, Sergio Ledda, Emilio Arsenio Martinez, Ana J Soler, Jordi Roca, María R Fernández Santos, Juan Maria Vázquez, Inmaculada Parrilla, Jose Julián Garde
The aim of this study was to assess the effect of insemination timing on pregnancy rates in red deer (Cervus elaphus) when using sex-sorted sperm samples. Semen was collected by electroejaculation from 8 mature stags and processed to obtain: Conventional samples, following standard freezing procedures for commercial purposes; Control sorted samples, diluted and handled as per sorted samples but without being submitted to the sorter passage; and Y Sex Sorted (YSS) samples. Hinds were synchronized via intravaginal CIDR (Controlled Internal Drug Release) placement and given eCG (Folligon® PMSG Serum Gonadotrophin) on day 12, upon CIDR removal...
March 9, 2018: Theriogenology
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Xin-Peng Dun, David B Parkinson
Injury to the peripheral nervous system triggers a series of well-defined events within both neurons and the Schwann cells to allow efficient axonal regeneration, remyelination, and functional repair. The study of these events has previously been done using sections of nerve material to analyze axonal regrowth, cell migration, and immune cell infiltration following injury. This approach, however, has the obvious disadvantage that it is not possible to follow, for instance, the path of regenerating axons in three dimensions within the nerve trunk or the nerve bridge...
2018: Methods in Molecular Biology
Stephen Honeybul, David Anthony Morrison, Kwok M Ho, Christopher R P Lind, Elizabeth Geelhoed
OBJECTIVE: To compare the long-term outcomes of patients who had been randomly allocated to receive primary titanium cranioplasty or autologous bone graft following decompressive craniectomy. METHODS: Sixty-four patients had been previously enrolled and randomised to receive either their own bone graft or a primary titanium cranioplasty. Functional and cosmetic outcomes had previously been assessed at 1-year following the cranioplasty procedure. Hospital records and the Picture Archiving communication system were reviewed to determine how many patients had cranioplasty failure or associated complications such as seizures beyond 1 year-with a minimum of 24-month follow-up...
March 15, 2018: Acta Neurochirurgica
Sudha S Shankar, R Ravi Shankar, Lori A Mixson, Deborah L Miller, Barnali Pramanik, Amy K O'Dowd, Donna M Williams, Clay B Frederick, Chan R Beals, S Aubrey Stoch, Helmut O Steinberg, David E Kelley
Oxyntomodulin (OXM), an enteroendocrine hormone, causes appetite suppression, increased energy expenditure, and weight loss in obese humans via activation of GLP-1 and glucagon receptors. However, the effects of OXM on glucose homeostasis remain ill-defined. To address this gap, we evaluated the effects of an intravenous (IV) infusion of native OXM on insulin secretory rates (ISR) and glycemic excursion in a graded glucose infusion (GGI) procedure in two separate randomized, placebo-controlled, single dose crossover trials in 12 overweight and obese subjects without diabetes, and in 12 obese subjects with Type 2 diabetes (T2DM) respectively, using the GLP-1 analog, liraglutide as a comparator in the T2DM...
March 15, 2018: Diabetes
David P Darrow, Coridon Quinn, Huy T Donguyen, Matthew Hunt, Stephen Haines
INTRODUCTION: External ventricular drains can pose a serious source of morbidity and mortality. Interventions proven to reduce the risk of infections are lacking. Single center studies limit the study of procedures that mitigate infection, but bundled protocols have demonstrated utility. A collaborative EVD registry was designed to facilitate local quality improvement projects to be implemented at any location using standardized data collection instruments through resident collaboration to reduce and study EVD infection and prevention...
March 12, 2018: World Neurosurgery
Mark A Henry, David H Howard, Benjamin J Davies, Christopher P Filson
OBJECTIVE To examine how Medicare reimbursement for prostate biopsies was allocated to physicians, ambulatory surgical centers (ASC), and hospitals from 2012-2015. MATERIALS AND METHODS Using Medicare Provider Utilization and Payment Data (2012-2015), we assessed provider payments to physicians and ASCs for transrectal ultrasound-guided prostate biopsies (CPT 55700, 76842, 76972) for fee-for-service Medicare beneficiaries. Data were aggregated at provider-level for those reporting >10 biopsies per year. Hospital payments were estimated based on Outpatient Prospective Payment System...
March 12, 2018: Urology
William J McIlvane, Joanne B Kledaras, Christophe J Gerard, Lorin Wilde, David Smelson
A few noteworthy exceptions notwithstanding, quantitative analyses of relational learning are most often simple descriptive measures of study outcomes. For example, studies of stimulus equivalence have made much progress using measures such as percentage consistent with equivalence relations, discrimination ratio, and response latency. Although procedures may have ad hoc variations, they remain fairly similar across studies. Comparison studies of training variables that lead to different outcomes are few. Yet to be developed are tools designed specifically for dynamic and/or parametric analyses of relational learning processes...
March 12, 2018: Behavioural Processes
David S Jevotovsky, Allyson R Alfonso, Thomas A Einhorn, Ernest S Chiu
OBJECTIVE: Osteoarthritis (OA) is a leading cause of disability in the world. Mesenchymal stem cells (MSCs) have been studied to treat OA. This review was performed to systematically assess the quality of literature and compare the procedural specifics surrounding MSC therapy for osteoarthritis. DESIGN: PubMed, CINAHL, EMBASE and Cochrane Central Register of Controlled Trials were searched for studies using MSCs for OA treatment (final search December 2017). Outcomes of interest included study evidence level, patient demographics, MSC protocol, treatment results and adverse events...
March 12, 2018: Osteoarthritis and Cartilage
Aida Kamišalić, David Riaño, Tatjana Welzer
BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions...
May 2018: Computer Methods and Programs in Biomedicine
Nelly Olova, Felix Krueger, Simon Andrews, David Oxley, Rebecca V Berrens, Miguel R Branco, Wolf Reik
BACKGROUND: Whole-genome bisulfite sequencing (WGBS) is becoming an increasingly accessible technique, used widely for both fundamental and disease-oriented research. Library preparation methods benefit from a variety of available kits, polymerases and bisulfite conversion protocols. Although some steps in the procedure, such as PCR amplification, are known to introduce biases, a systematic evaluation of biases in WGBS strategies is missing. RESULTS: We perform a comparative analysis of several commonly used pre- and post-bisulfite WGBS library preparation protocols for their performance and quality of sequencing outputs...
March 15, 2018: Genome Biology
Jacob Y Cao, Seung Yeon Lee, Kevin Phan, Julian Ayer, David S Celermajer, David S Winlaw
The hybrid strategy is an alternative to the traditional Norwood procedure for initial palliation of infants with hypoplastic left heart syndrome (HLHS) who are deemed to be at high surgical risk. Numerous single-center studies have compared the two procedures, showing similar early outcomes, although the cohort sizes are likely insufficiently powered to detect significant differences. The current meta-analysis aims to explore the early morbidity and mortality associated with the hybrid compared to the Norwood procedure...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Jamie S Penk, S Javed H Zaidi, Cheryl A Lefaiver, Supitcha Muangmingsuk, Vivian W Cui, David A Roberson
BACKGROUND: Quantifying right ventricular function in patients with a systemic right ventricle (RV) is difficult but important for prognosis. Tissue motion annular displacement tracks displacement of the tricuspid annulus toward the apex. We evaluated this measure alongside fractional area change (FAC) on patients with single, RV prior to the bidirectional Glenn procedure. We tested both measures for correlation with outcomes. METHODS: Retrospective measurement of tissue motion annular displacement and FAC was performed on echocardiographic clips obtained prior to the bidirectional Glenn...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Laura J Olivieri, David Zurakowski, Karthik Ramakrishnan, Lillian Su, Fahad A Alfares, Matthew R Irwin, Jenna Heichel, Axel Krieger, Dilip S Nath
BACKGROUND: Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery. METHODS: Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Carol Kelly, James D Chalmers, Iain Crossingham, Nicola Relph, Lambert M Felix, David J Evans, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life...
March 15, 2018: Cochrane Database of Systematic Reviews
Justyna Bartoszko, Duminda N Wijeysundera, Keyvan Karkouti, Jeannie Callum, Vivek Rao, Mark Crowther, Hilary P Grocott, Ruxandra Pinto, Damon C Scales, Blaine Achen, Sukhpal Brar, Doug Morrison, David Wong, Jean S Bussières, Tonya de Waal, Christopher Harle, Étienne de Médicis, Charles McAdams, Summer Syed, Diem Tran, Terry Waters
BACKGROUND: Research into major bleeding during cardiac surgery is challenging due to variability in how it is scored. Two consensus-based clinical scores for major bleeding: the Universal definition of perioperative bleeding and the European Coronary Artery Bypass Graft (E-CABG) bleeding severity grade, were compared in this substudy of the Transfusion Avoidance in Cardiac Surgery (TACS) trial. METHODS: As part of TACS, 7,402 patients underwent cardiac surgery at 12 hospitals from 2014 to 2015...
March 15, 2018: Anesthesiology
Kurt P Spindler, Laura J Huston, Kevin M Chagin, Michael W Kattan, Emily K Reinke, Annunziato Amendola, Jack T Andrish, Robert H Brophy, Charles L Cox, Warren R Dunn, David C Flanigan, Morgan H Jones, Christopher C Kaeding, Robert A Magnussen, Robert G Marx, Matthew J Matava, Eric C McCarty, Richard D Parker, Angela D Pedroza, Armando F Vidal, Michelle L Wolcott, Brian R Wolf, Rick W Wright
BACKGROUND: The long-term prognosis and risk factors for quality of life and disability after anterior cruciate ligament (ACL) reconstruction remain unknown. Hypothesis/Purpose: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years...
March 2018: American Journal of Sports Medicine
Lucía Fernández, Alejandra Leivas, Jaime Valentín, Adela Escudero, Dolores Corral, Raquel de Paz, Maria Vela, David Bueno, Rebeca Rodríguez, Juan Manuel Torres, Mariana Díaz-Almirón, Eduardo López-Collazo, Joaquin Martinez-Lopez, Antonio Pérez-Martínez
BACKGROUND: Cancer immunotherapy involving natural killer (NK) cells has gained interest. Here we report two methods to obtain interleukin (IL)-15-activated NK cells for clinical use. STUDY DESIGN AND METHODS: IL-15-activated NK cell products were obtained after 1) enrichment from healthy haploidentical donors' peripheral blood mononuclear cells (PBMNCs) collected by nonmobilized apheresis by a two-step magnetic procedure, depletion of CD3+ cells followed by selection of CD56+ cells and ex vivo overnight stimulation with IL-15 (NKIL15); and 2) expansion using the K562-mb15-41BBL cell line (NKAE), from autologous PBMNCs from patients with multiple myeloma or expansion from healthy haploidentical PBMNCs obtained from whole blood using the same previous cell line...
March 14, 2018: Transfusion
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